FMEA Techniques Application For Medical Reimbursement : The Case Study At Patong Hospital in Phuket

Abstract

The objectives of this study were to analyze problems in the working of each department related to the process of medical reimbursement using the Failure Mode and Effect (FMEA) techniques to adjust the process of the medical reimbursement according to the suggested solutions to the problem from the result of FMEA techniques, and to survey the satisfaction of the participants who joined to analyze the problem after the adjustment of the process using FMEA techniques. This study was both a qualitative and quantitative research whose Participants came from the information technology and the medical record committees. Ten(10)participants where used in the qualitative research while the survey method was used to collect data on the satisfaction of the related persons with the process of the medical reimbursement (61) participation. The result form the analysis of the work related problems of eachdepartment based on the process of the medical reimbursement using the FMEA techniques showed that there was an effect of the aspect of the failure mode for each of all the8 topics. The aspect of the effect of the failure mode showed that there were 37 causes which would create failure mode for each of the 7 topics. The value score of Severity, Occurrence, and Detection calculated with the risk priority number (RPN) had the highest value, of 280 scores and the least value at 48 scores. The result of the risk priority number when compared before and after the adjustment showed that this could reduce (by 82%) the amount of days used in the process of the medical reimbursement from 43 days to 23 days. As for the satisfaction after the adjustment of the process with FMEA techniques, it was found that it was in the medium level with an average of 3.479